Center Stage Psychology

Notice of Privacy Policies & Practices

Dr. Jacqueline Benson, Psy.D.

Center Stage Psychology deeply respects the privacy and confidentiality of our clients. Your health information is important and personal. We are dedicated to protecting the health information of our clients, complying with the legal requirements and ethical standards associated with the maintenance and care of health and medical information per California law.

This notice describes how protected health information (“PHI”) about you may be used and disclosed and how you can get access to this information. Please review it carefully.

I.               Confidentiality

As a rule, we (Center Stage Psychology/Dr. Benson) will obtain verbal and written authorization from you before using or disclosing your PHI which includes your status as a client in a way that is not indicated in this notice. Formal Mental Health Records are kept for clients receiving therapy services per ethical and legal standards and contain information including, but not limited to the nature of services provided, the dates and times of sessions, diagnostic information, relevant client history, mental health status, symptoms, progress and the results of any psychological reports and/or testing. We will obtain verbal and written authorization from you before using or disclosing your PHI both at the onset of treatment as well as via verbal and/or written authorization if the need for other disclosures arises. You may revoke such permissions at any time by informing us in writing.

Use & Disclosure Not Requiring Consent or Authorization

Some exceptions are required by law while others are informed by ethical standards and best practices. We may use or disclose PHI or other information about you without your consent or authorization including, but not limited to the following circumstances:

Health Care Operations: Providers of health care services are legally permitted to use or disclose records or information for purposes associated with the facilitation of treatment, payment and other health care operations such as bookkeeping, accounting and other typical health care operations.

Psychotherapy Notes: “Psychotherapy notes” are kept on clients as defined in 45 CFR § 164.501. Disclosure of such notes requires your authorization unless disclosure is: 1) within the course of treatment; 2) within the course of consultation with other professionals; 3)required by law; 4) required to assist in averting a serious threat to the health and safety of others; 5) required for use in defense during legal proceedings initiated by you; 6) within the training or supervision of mental health practitioners in which case all identifying information will be thoroughly deidentified per standard best practice. 

Emergencies: If you are involved in a life-threatening emergency and require emergency treatment PHI may be disclosed and we may seek to obtain your consent retroactively.

Child & Elder Abuse Reporting: Psychologists and other licensed mental health care providers are mandated reporters. If there is reason to suspect that a child and or elder has been subjected to abuse or neglect, we are required by California law to promptly make a formal report and to provide relevant information to the appropriate Child Protective Services and or Adult Protective Services agencies as instructed by local mandates.

 Threats to Health or Safety: If a client communicates to us a serious threat of physical violence against an identifiable victim or victim(s), we are legally required to make a reasonable effort to communicate that information to the potential victim or victim(s) and the police. If we have reasonable cause to believe that you are a danger to yourself or others, in addition to appropriate treatment referrals relevant information may be released as necessary to prevent such danger.  

Legally Required: PHI may be disclosed if such disclosure is required by state or federal law and the use and/or disclosure of such information is necessary for legal compliance or in the process of reporting a crime that occurred on our premises. If you are involved in a lawsuit or other legal proceedings such as child custody cases, or civil, criminal or administrative proceedings, PHI may be disclosed in response to court orders, subpoenas or other legal requests. However, all reasonable efforts will be made to inform you about such legal requests so that orders to protect PHI can be sought or authorization can be collected prior to disclosure if possible.

Workers’ Compensation: If you file a worker’s compensation claim we may be required to supply a report to your employer as well as subsequent reports as required by the Worker’s Compensation Commission to aid in determining your eligibility for worker’s compensation. Our preference is to obtain authorization from you prior to doing so.

Health Oversight: PHI may be disclosed during health oversight activities such as audits or investigations by Health & Human Services, the California Board of Psychology or other governing bodies.

II.              Client Rights

Right to Request Restrictions: You have the right to request restrictions on certain use or disclosures of your PHI. However, we are not required to agree or comply with such requests.

Right to Confidential Communications: You have the right to request receipt of billing and or appointment communications at alternative addresses or by alternative means.

Right to Inspect and Copy: You have the right to inspect or request an electronic or paper summary or copy of your medical record and other PHI in our mental health and billing records for the duration that such PHI is maintained. This excludes ‘psychotherapy notes’ (45 CFR § 164.501). Such requests must be submitted in writing and there may be a reasonable fee charged for the costs of copying and mailing.

Right to an Accounting of Disclosure: You have the right to request an account of the disclosures of your PHI for which you have not provided consent or authorization (see above). On your written request we will discuss with you the details of the accounting process.

Right to Amend: You have the right to request an amendment of your PHI. This request may be denied under such circumstances including, but not limited to: 1) the information was not created by the recipient(s) of your request; 2) the information is not part of the medical record kept by the recipient(s) of your request; 3) the information is not part of that which you would be permitted to inspect and copy; 4) the information is accurate and complete. If your request is denied you will be informed as to why in writing.

Right to a Paper Copy: You have the right to obtain a paper copy of this notice from us upon request, even if you have agreed to receipt of this notice electronically.

Right to Restrict Disclosures for Out-Of-Pocket Care: You have the right to restrict certain disclosures of your PHI to a health plan when you have paid in full out-of-pocket for our services.

III.            Policies on Safety of Client Information

Center Stage Psychology will never use or disclose your PHI for marketing purposes or sell your PHI under any circumstances.

Breach Notification: You have the right to be promptly notified if there is a breach involving your PHI. HIPAA Privacy Rule.

Electronic Communications: Center Stage Psychology will take all reasonable steps to ensure the safety and security of our clients’ personal information. We acknowledge that electronic communications can never be 100% secure and for this reason we will insist that all communication about client treatment and health records occur within the confines of our secure electronic health records as opposed to via typical email, text message or other electronic communications. If clients’ attempt to communicate with Center Stage Psychology or its associated clinicians about sensitive health information via these other means they will be redirected to the appropriate channels of communication.

Effective Date, Restrictions & Changes to Privacy Policy

This notice is in effect as of November 16th, 2021. We reserve the right to change the terms of this notice and to make new provisions effective for all PHI that we maintain as policies are updated. We will provide our clients with a revised notice via their preferred method selected upon receipt of the original notice.